Abbasi Amanullah, Bhutto Abdul Rabb, Alam Mohammad Tanveer, Aurangzaib Muhammad, Masroor Mohammad
Department of Medicine, Dow International Medical College, Karachi.
Department of Medicine, Tibri Hospital, Karachi.
J Coll Physicians Surg Pak. 2016 Jul;26(7):566-9.
To determine the frequency of hepatic hydrothorax and its association with Child Pugh Class in patients with liver cirrhosis.
Descriptive, analytical study.
Jinnah Postgraduate Medical Centre, Karachi, Medical Unit-III, (Ward- 7), from June 2012 to May 2013.
All patients with established diagnosis of decompensated chronic liver disease were included. Detailed history, thorough physical examination, routine laboratory investigations, chest X-ray and abdominal ultrasound were carried out in all patients to find out the presence of pleural effusion and ascites, respectively. Fifty milliliters of pleural fluid was aspirated in all patients with pleural effusion using the transthoracic approach, taking ultrasound guidance, wherever required. Fluid was sent for microscopic, biochemical, and microbial analysis. SBEM defined if pleural fluid with polymorphonuclear (PMN) cell count > 500 cells/mm3 or positive culture with PMN cell count > 250 cells/mm3 with exclusion of a parapneumonic effusion.
Two hundred and six patients met the inclusion criteria, with mean age of 41.25 ±13.59 years. Among them, 149 (72.3%) were males and 57 (27.7%) females. Twenty-three (11.2%) had hydrothorax; right sided involvement was in 18 (78.3%) subjects, 3 (13%) had left sided while bilateral pleural effusion was found in 2 (8.7%) cases. SBEM was found in 07 (30.43%) cases. Mean serum albumin 3.125 ±0.71 gram/dl. There was association between serum albumin levels and hydrothorax. Asignificant association of hydrothorax with Child Pugh scoring system (p=0.018), but not with serum albumin (p=0.15).
The frequency of hepatic hydrothorax has a significant association with hepatic function as assessed by Child Pugh scoring system, but not with serum albumin.
确定肝硬化患者肝性胸水的发生率及其与Child Pugh分级的关系。
描述性、分析性研究。
2012年6月至2013年5月，卡拉奇真纳研究生医学中心第三医疗单元（7号病房）。
纳入所有确诊为失代偿性慢性肝病的患者。对所有患者进行详细病史询问、全面体格检查、常规实验室检查、胸部X线检查和腹部超声检查，以分别确定是否存在胸腔积液和腹水。所有胸腔积液患者在超声引导下经胸穿刺抽取50毫升胸水，必要时进行。胸水送检进行显微镜、生化和微生物分析。SBEM定义为多形核（PMN）细胞计数>500个细胞/mm³的胸水或PMN细胞计数>250个细胞/mm³且排除类肺炎性胸腔积液的阳性培养结果。
206例患者符合纳入标准，平均年龄41.25±13.59岁。其中，男性149例（72.3%），女性57例（27.7%）。23例（11.2%）有胸水；右侧受累18例（78.3%），左侧3例（13%），双侧胸腔积液2例（8.7%）。7例（30.43%）病例发现SBEM。平均血清白蛋白3.125±0.71克/分升。血清白蛋白水平与胸水之间存在关联。胸水与Child Pugh评分系统有显著关联（p=0.018），但与血清白蛋白无关联（p=0.15）。
根据Child Pugh评分系统评估，肝性胸水的发生率与肝功能有显著关联，但与血清白蛋白无关联。
